Adv.Ravi Susha, Member
The complainant insured his cow with the opposite party for a sum of Rs.20,000/- on 29/07/2008. The policy No.is 442301/47/2009/22481.
The cow was undergone artificial insemination ten times at Government Veterinary Hospital, Mynagappally, but was in vain. Subsequently on examination at the Veterinary Hospital, Mynagappally. Dr.A.J.Biji certified that the cow will not get conceived. Veterinary Doctor G.Gopalakrishnan also issued
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such a certificate. Subsequently the petitioner applied for the insurance claim. But it was rejected by the opposite party saying that the Ear Tags of the cow which was put by the insurance company is lost. But at the time of examination by both the aforesaid Veterinary doctors it was there on the ear of the cow and that was mentioned in the certificate also.
The petitioner has spent a huge amount for maintain the cow. As a desperate farmer the petitioner had no other way but to approach the Forum for getting relief.
Opposite party filed version contending that the complainant is a member of Kidangayam Ksheerolpadaka Co-operative Society Ltd, No.Q 266, primary milk Co-operative Society under the operational area of M/s.TRCMPU Ltd. The complainant through Kidangayam Ksheerolpadaka Co-operative Society Ltd, had obtained an insurance policy for his Milk cow aged 5 years for a sum insured of Rs.20,000/- from this opposite party ear tag No.441200/97/7566, to a sum insured of Rs.20,000/- for a period commencing from 29/07/2008 to 28/07/2009. The ear tag containing the serial number is the only identification of the insured animal for the purpose of any claims arising under the policy. The complainant is liable to produce the ear tag of the animal as shown in the policy for making any claim under the policy and if the ear tag is not produced by the complainant, he is not eligible
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to receive any claim amount from the insurer. It is submitted that it is very specifically endorsed in the policy itself that “No Tag No Claim”. As per the policy condition the insured should surrender the ear tag at the time of any claim, otherwise the claim will be treated as ‘no claim’. The liability of the insurance company in any claim arising during the policy period is strictly based on the above policy conditions, which is the concluded terms of the contract agreed by both the contracting parties as per the MOU signed in this matter.
The complainant through Kidangayam Ksheerolpadaka Co – operative Society Ltd, No.Q 266, has reported a permanent total disability claim (PTD) to the opposite party along with the Veterinary certificate issued by Dr.Biji.A.J. Veterinary Surgeon, Veterinary Dispensary, Mynagappally. According to the report of the doctor the cow is not conceiving even after repeated artificial insemination and the doctor has recommended to consider the insured animal for a PTD claim. Though the doctor has mentioned the ear tag number 441200/97/7566 is missing. The complainant himself in para 7 of the complaint has admitted that he has not produced the relevant portion of the ear tag before the insurance company, for which the claim has not settled by the company till the date of filing of this complaint. The complainant in para 7 of the complaint has admitted that, the relevant ear tag showing the identity of the insured animal has lost some time much prior to the claim and as such he
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could not produced the ear tag before the insurance company. Even though the ear tag was missing, the complainant did not informed the matter immediately to the insurance company in order to get the animal retagged. So the complainant has willfully violated the terms and conditions of the MOU and the policy condition and as such he is not eligible to claim any amount from the insurance company. Due to the above willful violation of the policy condition, this opposite party has no contractual obligation to indemnify the insured /complainant in this case to the extent of admissible claim under the policy.
From the side of complainant PW1 & PW2 were examined. Exts.P1 to P4 marked. From the side of opposite party Exts.D1 to D3 were marked.
The points that would arise for consideration are:
- Whether there is any deficiency in service from the part of opposite parties?
- Compensation and cost
Points:
There is no dispute that at the time of claiming the insurance policy, the cow of the complainant had a valid insurance policy. The grievance of the complainant is that though he submitted claim with supporting documents
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after the Veterinary surgeons certified that the cow will not be conceived, the opposite parties did not allow his claim.
According to the opposite parties the complainant has not produced the ear tag of the insured animal as stipulated in the policy during the period which the claim preferred by the complainant. Hence they are unable to settle the claim of the complainant.
Here the question to be decided is whether the compliant is entitled to get the claim amount. The only dispute regarding to the rejection of claim is non-production of ear tag of the cow. According to the complainant, the portion of ear tag was somehow lost. PW2, Dr.Gopalakrishnan, Veterinary Surgeon deposed that while he examined the cow there was ear tag seen in the cow. In the reply to the claim form of Veterinary Surgeon (Ext.P3) the insurance company asked for submission of ear tag. That was dated on 11/08/2009. It is happened within one month from the date of inspection of PW2. The opposite party in the version admit that the complainant had produced a portion of ear tag along with the claim form. After perusal of all these contentions from both sides we arrived a conclusion that the complainant is entitled to get relief.
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The next point to be decided is what amount is entitled to the complainant. Here the complainant insured the cow with the opposite party for a sum of Rs.20,000/- in the event of a permanent total disability . As per Ext.D2 MOU, the complainant is entitled to get 75% of the sum insured is Rs.15,000/-. Here on the basis of Ext.P2 and P3 there is no dispute that the cow has permanent total disability for conceiving. From the deposition of PW1 and from Ext.D3 sale order it is revealed that the cow was sold for an amount of Rs.4,000/-. So the complaint is entitled to get Rs.11,000/- from the opposite party.
In the result, the complaint is allowed in part. Opposite party is directed to give Rs.11,000/- to the complainant. Opposite party is also directed to give Rs.1000/- as cost to the proceedings. This order has to be complied with within one month from the date of receipt of this order. Failing which the amount of Rs.11,000/- will carry 9% interest from the date of order till the date of payment.
Dated this the 13th day of July 2012.
G.Vasanthakumari:Sd/-
Adv.Ravi Susha :Sd/-
R.Vijayakumar :Sd/-
